Placenta

Gross processing

Determine the shape of the placenta
Look for any accessory lobes
Determine the completeness of placental membranes, opacity, color and consistency (slimy/slippery?)
Determine point of rupture from nearest margin
Note where the membranes are inserted
Examine the umbilical cord

Measure the distance between the insertion point and the nearest placental margin
Measure the cord length and give proximal and distal diameter
Count the number of vessels away from the insertion

Weigh the trimmed disk, after having trimmed away the cord and membranes, and after having removed excess amounts of loose retroplacental blood clots over the maternal surface.
Examine the fetal surface (chorionic plate):

Note its color
Look for any pathologies including granular excrescences, subchorionic fibrin or subamniotic hemorrhage
Look at the integrity and extent of the vasculature, including any thrombosis and traumatic damage

Examine the maternal surface (basal plate) for completeness, adherent blood clots, depressions, calcifications and fibrin
Take membrane rolls and cord sections, before sectioning the placenta
With the fetal surface down on the cutting board, cut the placenta at 1cm intervals so that it can be reconstructed
Palpate the parencyhmal sections for areas of induration.
Note the color of the parenchyma and describe any pale areas, cysts, infarcts (estimate total amount of infarcted tissue), thrombi, increased fibrin and calcifications

Distal (toward fetus) membrane roll and cross section of distal cord
Proximal (toward placenta) membrane roll and cross section of proximal cord ( 2-3 cm from insertion)
Placental section including fetal surface ( full thickness if possible)
Placental section including maternal surface (full thickness if possible)
Any lesions or abnormalities

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